Recently I had the chance to see first hand how easily a new mother and her breastfeeding can be undermined. A dear friend’s younger sister Sarah had her first baby two weeks ago. Four days after the birth I received a frantic call from my friend in Connecticut. I arrived to find an exquisite and healthy little girl and a broken down distraught new mother.

“I called the lactation consultant and she was here yesterday with her her scale. She watched Eliza eat and said she wasn’t an ‘efficient sucker’. She told me to feed her for 5 minutes on one side and then she weighed her. She said she wasn’t getting enough and that I had to increase my milk production. I am supposed to feed her until she falls asleep – then wake her and supplement with formula and then pump as much as I can.” Tears streaming down her face she sobbed, “Look at my nipples, they are shredded.”

I hate this story and unfortunately we are hearing ones like it more and more over the past few years. Breast feeding is the process of a mother and her baby’s bodies, newly separated at birth, learning to get back in sync in a new way. It is a process that takes time, patience and faith. Ideally new mothers will be supported by veteran breast feeders who, rather than focusing on milk production and weight gain, will help them tolerate and accept the often painful and slow process.

“We are going to forget about everything you’ve heard so far and start from scratch, so get those boobs out and let’s start,” I said.

For the next four hours I had the pleasure of tending to Sarah, bringing her warm compresses and lots of water as we dished over family gossip and carefully watched Eliza. I taught Sarah the critical importance of recognizing signs of hunger and of fullness. As simple as this sounds it is the key ingredient in the healthy feeding of your child. During this time she had two feedings with 3 hours of sleep and big blue-eyed wakeful periods in between. Sarah was amazed that her baby was full after only ten minutes of nursing and really did not need to eat for another three hours. Yes, she needed attention: rocking, swaddling, pacifier and even to be left alone and to sleep. Turns out Eliza is a very efficient sucker. What her mother needed was reassurance that the two of them together had everything they needed. We banished the pump and the scale. I taught Sarah to not read every squeak and squirm as a sign of hunger. Two weeks later mother and baby are thriving and Sarah owes me big time – just kidding.

In our fast-paced, product-oriented society, nursing a baby has become yet another human process that is driven by perfectionistic anxiety. Because so many new mothers are alone and isolated from other women, the practice of calling on professionals to help has become the norm. Unfortunately, it is hit or miss as to whether the consultant supports or intrudes and so derails the unfolding process with it’s inevitable pain and the leap of faith it takes to trust your body. (We know how easy that is for women!)

Erica Jong, author of Fear of Flying, feminist and mother writes a truly provocatice article in the Wall Street Journal entitled, Mother Madness. She exposes attachment parenting for what it is–a prison for women. It highlights that the race for the perfect child is a strategy to ignore bigger problems and politics. Here are some excerpts, but do read the whole article.

Unless you’ve been living on another planet, you know that we have endured an orgy of motherphilia for at least the last two decades. Movie stars proudly display their baby bumps, and the shiny magazines at the checkout counter never tire of describing the joys of celebrity parenthood. Bearing and rearing children has come to be seen as life’s greatest good. Never mind that there are now enough abandoned children on the planet to make breeding unnecessary…

Someday “attachment parenting” may be seen as quaint, but today it’s assumed that we can perfect our babies by the way we nurture them. Few of us question the idea, and American mothers and fathers run themselves ragged trying to mold exceptional children. It’s a highly competitive race…

Our obsession with parenting is an avoidance strategy. It allows us to substitute our own small world for the world as a whole. But the entire planet is a child’s home, and other adults are also mothers and fathers. We cannot separate our children from the ills that affect everyone, however hard we try. Aspiring to be perfect parents seems like a pathetic attempt to control what we can while ignoring problems that seem beyond our reach…

Some parenting gurus suggest that helicopter parenting became the rage as more mothers went to work outside the home. In other words, it was a kind of reaction formation, a way for mothers to compensate for their absence and guilt and also for the many dangerous and uncontrollable things in the modern family’s environment. This seems logical to me. As we give up on ideals of community, we focus more and more on our individual children, perhaps not realizing that the community and the child cannot be separated…

In the oscillations of feminism, theories of child-rearing have played a major part. As long as women remain the gender most responsible for children, we are the ones who have the most to lose by accepting the “noble savage” view of parenting, with its ideals of attachment and naturalness. We need to be released from guilt about our children, not further bound by it. We need someone to say: Do the best you can. There are no rules.

New mother’s returning to work are in a highly sensitized state. Since child birth and new motherhood are such charged and radically new experiences, the return to work can be seen as anything from devastating to a perfect escape, and all the points in between. What most women have in common is a fear about leaving their baby with a new caretaker who may be largely unknown. Tremendous guilt around leaving their baby or because they are ashamed they are not feeling bad about leaving the baby is also common. There is worry about not being able to accomplish their old job at the same level of competency and there are usually ambivalent feelings about the job itself since all values and priorities are shaken and changing. Of course there are also feelings of missing the baby and the idea that they “should” be at home. It is a very complicated and tender time but often women get back into a rhythm in a few months.

The new law will go a long way to begin to help women more seamlessly move from their nursing identity to their professional identity. At this time these two identities are very hard to reconcile for most women. One way to do this is to educate mothers that the nursing experience is more flexible than they are lead to believe. Many women can nurse in the morning, when they arrive at home and before their baby goes to sleep or in the middle of the night. They may not need to encumber themselves with the pumping process at work at all and may enjoy their nursing experience more that way. If a mother decides to pump at work, acknowledgement that she is nursing and plans to take time at work to pump breast milk is the most important factor. Most women are embarrassed or even frightened to bring it up to bosses both male and female. Having a policy in place that is discussed BEFORE the maternity leave would be tremendously helpful in setting the stage for a better transition. Any workplace that provides a comfortable, private space for pumping will help to lessen the feelings of shame or uncertainty regarding their nursing status.

The Breastfeeding Information Council recently released a 5 step guide for nursing moms returning to work. Below is an expert from this write up that speaks specifically to the importance of preparing for this transition in advance.

This is the most critical step of all. For many women, the decision to breastfeed is both personal and private. BBIC research indicates that 53% of working mothers claim that they do not feel the need to discuss their intention to pump with their employer. Of those that do, only 35% initiate the conversation with their employer prior to their maternity leave.16 Yet, planning ahead ensures greater peace of mind for the employee when she knows that she is supported in her decision to continue to breastfeed after returning to work. It also helps the company prepare for a new mother’s return to work.

here are some helpful tips to ensure the conversation happens:

• Discuss the employee’s plans for breastfeeding, including whether she intends to pump when she returns to work and for how long; understand that while plans may be discussed prior to leaving, those plans may change

• If you are not comfortable having this discussion with your employee, find someone who is – perhaps another mother or a colleague with whom she is close

• Provide her with the company’s written policy, as well as any other supporting material that you may have to help her prepare for her return to work and a sample policy is included Appendix B

• Listen and have a two-way dialogue – understand that a working mother’s needs may vary and some flexibility may be required

• Explain that the company and its staff are fully supportive of the new mother in her choice to continue breastfeeding, and outline the process for filing a complaint about any harassment to which she may be subjected.

Appendix C contains a handout with helpful tips for a new mother returning to work.

“If a mother decides to pump at work, acknowledgement of her decision is the most important factor in helping her feel supported when she returns to work. Many women are embarrassed or even frightened to bring up the topic of breastfeeding with both male and female supervisors. Having a policy in place that is discussed BEFORE the maternity leave would be tremendously helpful in setting the stage for a better transition.”17

Lisa Spiegel, M.A., LMHC, Soho Parenting Center, BBIC Advisory Board

“It’s important that employees communicate with their employers, preferably while still pregnant, and let them know that they intend to pump when they return to work. You want to give your company as much opportunity as possible to come up with a suitable arrangement for you – you don’t want to spring it on them that you need a place to pump on your first day back.”18

A good breastfeeding policy doesn’t need to be complex. It simply needs to include the essentials of how the company supports its nursing mothers. Appendix B has a sample breastfeeding policy template that can be used to develop your own.

The policy should be written in the same tone and voice as your other corporate policies and should:

• Clearly state that the company supports nursing mothers returning to the workplace and that all staff are expected to do the same

• Summarize the legal requirements for complying with the Healthcare Reform Act

• Define or suggest reasonable break times and state whether these are paid or unpaid

• List private places where a nursing mother can pump

• State that the policy will be discussed with nursing mothers prior to their departure on maternity leave

• Provide a means for a nursing mother to lodge a complaint if she feels that she is being harassed or discriminated against because of her decision to pump at work

“A mother will try and replicate the frequency of her breast emptying while at work with a breast pump. Frequent pumping will allow her to continue to produce breast

milk, so that she can provide her baby with expressed breast milk for the following day.”14 Shery Leeder, IBCLC, BBIC Advisory Board

“Novice pumpers are undertaking something that is new and unfamiliar to them. They have to adjust to the fact they’re expressing their breast milk while their work world

swirls around them. This can translate into difficulties relaxing, which can lead to the need for a longer break for pumping, especially in the beginning.”15 Carole Lucia, Contributing Editor, Breastfeeding and Health, Fit Pregnancy

Food- we can’t live with it and we can’t live without it. This age old lament is sadly how many women experience their relationship to eating, weight and food. Food can be one of our greatest pleasures as well as our most oppressive jail. Once we become mothers we are highly influential in helping form our child’s relationship to eating. This excerpt from A Mother’s Circle takes a closer look at the topic of food and motherhood and all that it encompasses:

Food plays a powerful, elemental role in our lives. It is, and always will be, associated with deeply cherished rituals and celebrations. Tastes and aromas can unlock childhood memories. Meals and eating give a rhythm to the days and mark the passage of seasons and holidays. Feelings about food, eating, and mealtimes from your own childhood will affect your response to feeding your baby.

In addition to one’s own personal history about food, present day attitudes also affect the feeding of your baby. Our culture presents dual, incompatible fantasies: first, a “perfect” (thin) body equals happiness, and second, that fast food is all-American fare. Unavoidable images of model-sleek women pull the rug out from the average female’s respect for her own body and distort her natural appetite. For many teenage girls and women, diet soda and self-denial are a way of life and anorexia is the challenge that symbolizes this. For others, over-indulgence is a different form of obsession. Meanwhile, junk food, fast food and caffeine-laced soft drinks are staples of our national diet. Obesity has become a primary health concern across the country: sixty percent of Americans are overweight.

So even if you have not personally struggled with an eating disorder, it is impossible not to be affected by the cultural norms and expectations about weight and diet. As a mother embarking on the process of teaching another human being about food, it can be helpful and important to look at your own feelings about food, weight and body image.
Many mothers recall tremendous pressure to be thin or conversely, to finish all the food on their plate. By examining your own family of origins’ attitudes about weight and eating you can become aware of unconscious worry that may be provoked by feeding your baby. Many new mothers worry about under- or overfeeding their babies. Monthly visits to the pediatrician that confirm an average and steady weight gain do little to help. Sometimes this worry is set off when a mother and baby have a difficult time getting started with breastfeeding or when, for example, a baby has been extremely fussy and seems to find relief only when she is eating. If a mother’s preoccupations linger despite the fact that her baby is thriving, her own history may offer an explanation.

Many mothers confide that though they never had a weight problem themselves, a siblings’ struggle with food or weight has affected them. These feelings can get tangled up in the feeding process with your new baby and take away from the pleasure of nourishing your infant.
It is no wonder, given all these influences, that some mothers do not trust their babies’ appetites either. But they can. A healthy baby will naturally eat the amount she or he needs. Mothers offer a great gift to their children by giving them a sense of control over the eating process, as well as a natural, unencumbered appreciation for food.

The Case Against Breast Feeding by Hanna Rosin appears in the April issue of The Atlantic. The title is sensationalistic. The content of the article addresses inconsistent findings in medical literature about the superiority of breast feeding, the snobbery of the 21st century perfectionistic supermom, and the possibility that the pressure to nurse is a new form of prison for women. All interesting. In our previous post on breast feeding we addressed some of these same issues. Judith Warner, of the New York Times reacts to this article with admiration and the anticipation of reprisal. While she applauds Rosin’s challenge to present day pressure on women to exclusively breast feeding, she fears the backlash. “I am sure that … the Dr. William Sears-inspired attachment parenting crowd will soon assail her in the blogosphere.”

We are struck that both Rosin and Warner still look to Dr. Sears and his disciples for affirmation. We were hoping we were about done with Dr. Sears and “attachment parenting”. I can’t count the number of mothers who have come to Soho Parenting with Post Sears Traumatic Disorder. Here are the symptoms: debilitating guilt, exhaustion, crying outbursts, marital conflict and a baby who cannot sit or play independently for more than two minutes. Of course, that could describe any new mother, but the followers of Sears have a special brand of this overwhelmed state. They have drunk the Sears Kool-Aid that 24/7 nursing, holding, “bonding” with your baby is the only way to secure the mother baby attachment. They come for guidance when their babies are 6, 9, 12 months, feeling like complete failures. They just can’t manage what Martha Sears has purportedly done with her 11 children.

The detox program we offer is simple. Feed your baby during the day when she should be eating. Have them sleep from a nice early bedtime until morning. Honor your babies need for comfort, connection and love as well as for solitude and their capacity to use and develop their own resources.